Security

Fraud Report

Company Name:

First Name:

Last Name:

Email:

Date of Incident:

Time of Incident:

Fraudulent Name: Fraudulent Email: Last 4 Digits of Credit Card: Fraudulent Address:

Additional Details:

Report Fraud

If you’re one of Colorcubic’s partners and/or clients, and you’ve experienced an instance of fraud with one of your e-commerce platforms, please fill out the following form, submit, and download the fraud report, to remain in compliance with your internal PCI-DSS document.

Company Name

First Name

Last Name

Select...

Date of Incident

Approximate Time

Number of Fraudulent Accounts

Select Credit Card Type

Select Fraud Type

Credit Card Fraud Identity Theft Compromised Login Credentials Fraudulent Charge Backs

Upload Screenshots

Describe Fraud Incident

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